Looking after
your bones

It is important to look after your bones and there are things that you can do to improve your bone health.

Eating a balanced diet with plenty of calcium (from dairy products, dried fruit and oily fish) keeps bones strong and healthy. Protein from fruit, vegetables and pulses (lentils and beans) is better for your bones than protein from meat. Soy-based products, such as tofu, also improve bone health.

Vitamin D from sunshine, food or supplements helps your body absorb more calcium. Giving up smoking and cutting down alcohol can also improve your bone health.

Gentle exercise makes bones stronger. Physical activity can also improve your co-ordination and balance, making you less likely to fall and get a fracture if you do have weaker bones. Exercises that make you work against gravity (weight-bearing exercise) are particularly good for bone health. These include walking, climbing stairs, dancing and gentle weight lifting.

If you want to make any changes to your lifestyle, you can talk to your doctor to make sure that the diet or exercise is suitable for you and the cancer you have.

Studies have shown that protein from fruit, vegetables and pulses (lentils and beans) is better for your bones than protein from meat.

Other studies have shown that including soy-based foods as part of a healthy diet can also improve your bone health.

Calcium

A daily intake of 700mg of calcium is recommended for adults. Eat foods that are rich in calcium, such as:

dairy products

leafy green vegetables, for example broccoli and curly kale

soya beans, kidney beans and baked beans

dried fruit, for example, figs, apricots and raisins

fish – you should have two portions of fish a week, one of which should be oily fish like salmon or sardines tinned in oil.

If you have a dairy-free diet, make sure it includes other non-dairy foods that contain calcium.

Some food and drinks upset the calcium balance in the body. These include caffeine, red meat, salt and fizzy drinks that contain phosphates, such as cola. Avoid having large amounts of these.

Vitamin D

Vitamin D helps your body absorb calcium, so it’s important to get enough of it.

We mainly get it through sunlight, which the body converts into vitamin D. This is then stored in our fat. People with naturally dark skin need more sunlight to make vitamin D.

Most people get enough vitamin D for the whole year by being out in the sunshine without sunscreen for a few minutes regularly during the summer. How much sunshine you need depends on a number of factors, such as the time of day and your skin type and colour. You should always avoid getting burnt.

Although most of our Vitamin D comes from sunlight, eating foods that contain Vitamin D can also help. These include cooked salmon and mackerel, tuna tinned in oil, sun dried mushrooms and cod liver oil.

If you don’t go out enough, or if you need to cover up when in the sun, you may need to take vitamin D supplements. Vitamin D can be found in some fish oil supplements, including cod liver oil. But these supplements may interfere with the way some chemotherapy drugs work. If you’re having chemotherapy, ask your cancer doctor whether it’s alright for you to take these supplements at the same time.

If you’re having cancer treatments that increase your risk of osteoporosis, you may need to take vitamin D and calcium supplements. Ask your GP or hospital doctor if you need to take them.

a half pint of stronger (5%) beer, lager or cider contains one and a half units

a standard glass of wine (175ml) contains two units

a large glass of wine (250ml) contains three units

a single measure (25ml) of spirits contains one unit.

Drinking large quantities of alcohol in one session (binge drinking) is thought to be worse for your health than drinking a small amount each day. It’s also recommended that people have one or two alcohol-free days each week.

Get physically active

Physical activity makes bones stronger. Exercise can also improve your coordination and balance, which may make you less likely to fall and get a fracture.

How much exercise you do depends on your cancer, its treatment, how fit you are and what you want to achieve. There are lots of different ways to exercise. It’s best to find something that you enjoy so you’ll carry on with it and not get bored.

Exercise that makes you work against gravity (called weight-bearing exercise) is best for your bones. This includes walking, climbing stairs, dancing, hiking and gentle weight training. Swimming isn’t a weight-bearing exercise, but it’s a good way to get fit.

If you have a high risk of fractures or you’ve had a fracture in the past, you should avoid high-impact exercises like excessive running. This is because they can lead to stress fractures.

As a guide, regular exercise is usually defined as 30 minutes of activity five times a week. The 30 minutes could be made up of three 10-minute periods of activity. Don’t push yourself too hard. At the end of an activity, you should feel warm and slightly out of breath, but not exhausted. With practice, you’ll soon find you’re able to do more.

If you haven’t exercised much before, you’ll need to start slowly. Get advice from your GP. They can tell you if there are any exercises you should avoid and if there are any exercise schemes in your area. Here are some tips for getting started:

Walking is good exercise. Start off with short walks at a comfortable pace, then slowly increase the speed and distance. Walking to the shops, taking children to the park and walking the dog all count. If you drive to work – park the car a short distance from work and walk to the building.

Take stairs instead of lifts. Climbing stairs uses up twice as much energy as walking on flat surfaces.

Housework can be a form of exercise. Listening to fast-paced music while you clean and tidy can help you do it faster and use more energy.

Gardening is a good way to get active and enjoy the fresh air. If you don’t have a garden, you could volunteer to help at a community garden. Your local volunteer centre can provide details.

Bowling and dancing are ways to get fitter while socialising.

If you have osteoporosis or you’ve had a fracture in the past, avoid sudden movements or exercises where you bend forward and twist your waist. These movements can increase your risk of fractures in the spine.

Thanks

We rely on a number of sources to gather evidence for our information. If you’d like further information on the sources we use, please feel free to contact us on: bookletfeedback@macmillan.org.uk

All our information is reviewed by cancer or other relevant professionals to ensure that it’s accurate and reflects the best evidence available. We thank all those people who have provided expert review for the information on this page.

Our information is also reviewed by people affected by cancer to ensure it is as relevant and accessible as possible. Thank you to all those people who reviewed what you're reading and have helped our information to develop.

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We make every effort to ensure that the information we provide is accurate and up-to-date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication or third party information or websites included or referred to in it.